Provider Demographics
NPI:1982438594
Name:INTRON LLC
Entity type:Organization
Organization Name:INTRON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:SUMNER
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:314-832-2480
Mailing Address - Street 1:4365 CHIPPEWA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-1606
Mailing Address - Country:US
Mailing Address - Phone:314-832-2480
Mailing Address - Fax:314-832-2498
Practice Address - Street 1:4365 CHIPPEWA ST STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1606
Practice Address - Country:US
Practice Address - Phone:314-832-2480
Practice Address - Fax:314-832-2498
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTRON LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-27
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy